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Individual

CHANDRA GIRDHARI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1412 MILSTEAD AVE NE, CONYERS, GA 30012-3877
(770) 918-3000
Mailing address
850 ORMEWOOD AVE SE, ATLANTA, GA 30316-2435
(305) 814-3253

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
078583
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
304447500
FL
01
430064761
RAILROAD MEDICARE
01
G2853
BC/BS FL
FL
Enumeration date
02/16/2006
Last updated
10/05/2016
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